Course Of Thyroid Cancer Research Articles

Trend analysis of thyroid carcinoma incidence: a retrospective analysis of 2705 cases from an endemic goiter region Runnig title: Trend analysis of thyroid carcinoma an endemic goiter region

Introduction: To provide further data from a population with different genetic background for the contrary views on the ensuing question of “whether iodine status influence the onset and course of thyroid cancer (TC)” by examining trends in TC incidence and prevalence of main sub types of TC in a population from formerly iodine deficient geographic area in Turkey. Methods: Data were retrieved for 2,705 patients (2,161 female, 544 male) who were diagnosed with histopathologically confirmed thyroid cancer at Karadeniz Technical University Farabi Hospital, a university hospital serving a geographic region which remains an endemic goiter area and was formerly iodine-deficient, shortly after mandatory national salt iodization, between 2000 and 2018. Age, gender, subtype, tumor size, stage, and the changes and trends over the years were retrospectively evaluated. Results: Thyroid cancer rates had a trend of increase from 2000 to 2012 and then began to decline. In our region, PTC is more prevalent (93.5%). Among all thyroid cancers, the ratio of micro papillary thyroid cancer (mPTC) is 46.5%, FTC is only 3.5%. mPTC (tumor size ≤10 mm) (49.8%) and macroPTC (tumor size >10 mm) (50.2%) are approximately equal in proportion, and these ratios remained similar over the years covered in this analysis. Stage I PTC is 95.3%. M0 PTC is %98.9. Conclusion: Data from this retrospective epidemiologic study indicates that the rate of PTC is notably high and TC may have a more benign course in our endemic goiter region probably due to iodine supplementation that may affect late-stage thyroid carcinogenesis.

Implementation of molecular genetic tests in the diagnostics of thyroid cancer: own research

Aim — to investigate the significance of BRAFV600E, NRAS, KRAS, HRAS, RET/PTC (RET/PTC1 and RER/PTC3), PAX8/PPARg mutations for the development and course of thyroid cancer with the determination of a significant predictor mutation. Materials and methods. The analysis included 63 selected case histories of patients who, at the preoperative stage, underwent molecular genetic testing (MHT) of the thyroid gland (TG) masses and subsequently underwent surgical treatment in the surgical department of the Ukrainian Scientific and Practical Center for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues. The average age of the patients was 41.0 ± 1.8 years; from them 7men and56women. All patients underwent fine-needle aspiration puncture biopsy(FNAB) of thyroid nodules according to the standard method followed by a cytological conclusion in accordance with the Bethesda system.The Bethesda III category was revealed in 3 patients (4.8 %), Bethesda IV — 13 patients (20.6 %), Bethesda V — 12 patients (19.0 %), Bethesda VI in 35 (55.6 %) patients. The pathogenic mutations were detected in 47 (74.6 %) patients (group 1), among them two mutations were simultaneously found in two subjects. In 16 cases (25.4 %), no pathogenic mutation was found at all (group 2). Results. The genes that occurred most often were BRAFV600E — in 35 patients (55.6 %), NRAS — in 11 patients (17.5 %), KRAS — in 3 patients (4.8 %). In case of thyroid cancerdiagnosis, pathogenic mutations were found in 38 (79.1 %) subjects. The BRAFV600E gene mutation was observed when establishing a cytological conclusion classified as Bethesda III—V in 28.9 %, and in Bethesda V and in 77.1 %. Accordingly, the sensitivity of the test was low — 0.646, specificity — 0.733. The high prognostic significance of a positive result(PPV) value (from 0.784 to 0.943) indicated the likelihood of detecting thyroid cancer. This assumption confirms the calculation of the c-square criterion with the Yates correction, which is 5.207 (p = 0.023). The use of this test for the presence of the NRAS gene to detect thyroid cancer was ineffective, the value of the c -square criterion with Yates correction = 0.009 (p = 0.927). The incidence of thyroid cancer in group 1 in the cytological class Bethesda III—V was higher than in group 2, but it did not differ significantly between the groups. The aggressiveness of thyroid cancer in patients of group 1 with a positive MHT result did not have significant differences compared with the results obtained in group 2 (39.5 % and 33.3 %, respectively). Conclusions. The use of the kit for the determination of MHTmade it possible to identify pathogenic mutations in the genes BRAFV600E, NRAS, KRAS in 79.1 % of cases. The presence of these genes in combination with the analysis of cytomorphological findings classified according to the Bethesda III—V system did not increase the detection of thyroid cancer in the studied patients. The BRAFV600E gene, which was observed in 64.6 % of cases (PPV from 0.784 to 0.943), was a significant predictor among the studied candidate genes for establishing the diagnosis of thyroid cancer. Detection of a pathogenic mutation in patients with thyroid cancer did not indicate in favour of its aggressive course.

Increasing Incidence of Thyroid Carcinoma: Risk Factors and Seeking Approaches for Primary Prevention

Based on opinions published by many scientists about the increase in the incidence of thyroid cancer in many countries, this paper intends to identify research to be done on one hand with respect to reasons for this increase, the natural course of thyroid cancer and risk factors and - on the other hand - to support the clinician in primary prevention of thyroid cancer. Along with the traditionally discussed risk factors: ethnicity, heredity, sex effects/hormones, comorbidity, radiation exposure, diet (iodine), life-style (smoking), features of the natural environment, the effect of endocrine disrupters and in particular nitrates are also discussed. For the clinician, a simple approach for primary prevention of thyroid cancer is to refer the patient for a radiological examination applying ionizing radiation with exposure of the head and neck region only if the indication is justified according to the International Committee for Radiological Protection. In clinical practice, it is also important to take into account and minimize other risk factors: prevention of obesity and weight reduction, adequate treatment of various thyroid diseases, avoidance of excessive consumption of nitrates and other endocrine disruptors/ environmental pollutants. In case of a nuclear emergency, attention has to be paid for immediate withdrawal of contaminated food and drink as well as iodine thyroid blocking especially in vulnerable members of the population as children, pregnant or breastfeeding women. More research is also required to identify other reasons of the increasing incidence and predictors of aggressive vs indolent behavior of thyroid cancer to avoid unnecessary screening activity, overdiagnosis, and overtreatment.

Особенности течения рака щитовидной железы на фоне диффузного токсического зоба

Особенности течения рака щитовидной железы на фоне диффузного токсического зоба

Postępowanie w przerzutach do węzłów chłonnych w przebiegu raka tarczycy

We would like to present the specificity, technique and efficiency of neck surgery in patients with lymph node recurrence in the course of thyroid cancer treatment. In the ENT Department of Medical University in Poznań, Poland, 16 patients were operated for diagnosed neck relapse of thyroid cancer in the years 2000-2005. All of them were directed from endocrinology or general surgery units, where were previously treated by means of total/partial thyroidectomy: in 7 cases high grade folliculary cancer, in 6 medullary, in 2 oxyphilic and 1 anaplastic cancer. In 5 patients bilateral (one site radical, one site selective), in 11 unilateral neck dissection were performed. The thyroid gland cancer metastases were predominantly localized in the level IV (in 15 of 16 cases) and in anterior neck compartment, i.e. level VI (7 of 16 cases). In 6 patients the remnant of thyroid tissue were excised. Complication - recurrent nerve paresis occured in one case. The time of observation ranged from 5 to 57 months. The neck relapse was observed in one patient with undiffeentiated thyroid cancer in 8 month time after selective neck dissection. The rest of the group is free of disease.

Characteristics of thyroid carcinoma in Grave's disease Hashimoto's thyroiditis and nodular goiter

The biology of thyroid cancer represents a spectrum of behavior ranging from well-differentiated lesions with an excellent prognosis to anaplastic carcinoma, which is almost fatal. For this reason, it is important that clinicians have methods at their disposal to asses the characteristics of patient's thyroid malignancy. In this work we discuss the behavior of differentiated thyroid cancer in associated diseases of thyroid as: Graves' disease, chronic lymphocytic thyroiditis--Hashimoto and nodular goiter. This is retrospectively reviewing of 50 patients treated for differentiated thyroid carcinoma at Department of surgery, Clinical Centre of Montenegro in Podgorica from 1998 until 2003. We evaluated occurrence, as well as the role of this diseases in patients with thyroid cancer. We found a more favorable course of thyroid cancer in the presence of chronic lymphocytic thyroiditis and nodular goiter, a contrary Graves' disease. In associated diseases of thyroid, a significantly greater proportion of patients with thyroid cancer, have modular goiter.

Clinicopathological findings and p53 expression of thyroid cancer in children.

Although thyroid cancer tends to metastasize early in children, it is generally associated with a good prognosis. In this study, the expression of p53, mutations of which are found in many cancers, including anaplastic thyroid cancer, was examined to determine the relationship between cell proliferation and the clinical course of thyroid cancer. The clinicopathological findings and clinical courses of 15 children who underwent surgery before the age of 18 years at our hospital between 1972 and 1992 were examined, and the expression of p53 was studied using immunohistochemical techniques and an RNase protection assay. Postoperative follow-up ranged from 1 to 20 years, with a median of 12 years. No abnormal expression of p53 was detected in the thyroid cancer of any of the children tested, and none of them have died. The findings of this study therefore strongly suggest that p53 may play a role in the regulation of cell proliferation, and in this capacity slow the growth of and be related to the prognosis of differentiated thyroid cancer in children.